Viewpoint: Power and Communication: Why Simulation Training Ought to Be Complemented by Experiential and Humanist Learning

Purpose To survey third- and fourth-year medical students about their experiences performing gender-specific examinations. Method In 2001, 402 third- and fourth-year medical students at the University of Washington School of Medicine were mailed a questionnaire that asked them to approximate the number of pelvic, breast, and male genital examinations they had performed and to estimate the percentage of these examinations that were observed and the percentage that were repeated by a supervising physician. They were also asked to rate their confidence performing these examinations. Chi-square analysis and stepwise multiple regression analysis were performed. Results A total of 194 (48%) students completed the questionnaire. Fourth-year female students performed significantly more pelvic (p < .01) and breast examinations (p < .01) than did fourth-year male students. The percentage of examinations that were repeated by a supervising physician was low. Only 86 (45%) of third- and fourth-year students had greater than 75% of their breast examinations repeated by a supervising physician. Male students were less confident in performing the pelvic exam (p < .01) and female students were less confident performing the male genital exam (p < .01). The only predictor of confidence in performing each of these examinations was the number of examinations performed (p < .001). Confidence did not correlate with the percentage of exams observed, percentage of examinations repeated by a supervising physician, or student gender. Conclusions Student gender was a marker for suboptimal exposure for performing opposite-sex, gender-specific examinations. The only predictor of confidence in performing these examinations was the number of exams performed. Special efforts should be made to eliminate gender disparity in opportunities to perform gender-specific exams.